Does Medicare Cover Orthotics?
Medicare does cover orthotics that a doctor has deemed medically necessary, and as long as the doctor and orthotic supplier are enrolled in and participate in Medicare. Medicare Part B will typically cover 80% of the Medicare-approved amount.
If you have foot or back pain, a spinal injury, osteoarthritis or other orthopedic condition, your doctor may prescribe an orthotic device as a part of treatment. Learn more below.
Orthotics is a medical specialty concerned with the making and fitting of medical devices designed to support, align, relieve or correct orthopedic problems. These supportive orthotic devices are most commonly used to:
- Facilitate healing following an injury or surgical procedure
- Reduce pain by restricting mobility
- Support weak or deformed joints and muscles
Medicare Does Pay for Orthotics
There are a wide variety of orthotics (prefabricated and custom-made) prescribed to patients that Medicare covers under the durable medical equipment (DME) benefit. Medicare orthotics can include:
- Ankle, foot and knee bracing
- Back, neck and spinal bracing
- Hand, wrist and elbow bracing
- Orthopedic shoes when they're a necessary part of a leg brace
- Prosthetic devices such as artificial limbs and eyes
In order for Medicare to cover your orthotics:
- Your doctor or physician must determine that the orthotics are medically necessary and prescribe it as part of your treatment plan.
- The DME suppliers you use must be enrolled in and participate in Medicare.
What Medicare Will Pay
Generally, if you meet all of the requirements for getting coverage, Medicare Part B will cover 80% of the Medicare-approved amount for orthotics, and then you typically pay the 20% Medicare Part B coinsurance out-of-pocket (after your annual Part B deductible is met).